Sergeant Erik Howard (centre) Private Kevin Clark (right) and Jeremy Engelmann (left), a team of line medics, have responded to six bomb explosions in the last two months, with 14 soliders from their unit, C Troop of the 4/14 Cavalry, injured, six requiring helicopter evacuation.
Photo by Phil Sands, 25th Oct 2005 less

Sergeant Erik Howard (centre) Private Kevin Clark (right) and Jeremy Engelmann (left), a team of line medics, have responded to six bomb explosions in the last two months, with 14 soliders from their unit, C ... more

Photo: Phil Sands

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15,220 live with the wounds of war

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2005-10-27 04:00:00 PDT Rawa, Iraq -- Less than two months into his first tour as a combat medic with the U.S. Army, Sgt. Erik Howard has treated 14 wounded soldiers at the scenes of bomb blasts.

None of the men in his squadron, the 4th Squadron, 14th Cavalry Regiment, is among the 2,001 U.S. military personnel who have died in Iraq since the war began in March 2003. But for Howard and many other soldiers, death is not the main concern. They pay more attention to the ever-spiraling casualty rate.

As of Oct. 15, according to the Pentagon, 15,220 members of the U.S. military had been wounded in action since the Iraqi operation began in March 2003 -- 542 during the war that ousted Iraqi President Saddam Hussein and 14,678 since U.S. troops began battling the insurgency. Nearly half of those wounded were injured severely enough that they could not return to duty within 72 hours.

"Personally, I think there's a difference between living and being alive," Howard said. "A lot of us fear losing an arm or a leg; a lot of guys worry they'll get hurt and lose their genitals. It's the head injuries that are the worst, in my opinion. I fear getting a head wound -- having brain damage and still being alive, but not being able to care for my wife or kids."

Smoking a cigarette as he talked, the 27-year-old father of two from Florida said, "We all think about things like this -- we try not to, we try to distract ourselves with video games or talking trash, but you can't escape from this stuff. Not many of us worry about death except for the effect on our families."

Howard is serving on a dust-blown combat outpost near Rawa, a town on the Euphrates River in Anbar province, one of the hot spots of the insurgency. He heads a three-man combat medic team attached to a frontline battle unit. When soldiers are wounded, Howard, Pvt.Jeremy Engelmann, 21, from Sacramento, and Pvt. Kevin Clark, 28, from Texas, are expected to deal with the immediate consequences.

"The first thing that goes through your mind is 'Damn,' " Howard said. "Then you just pray everyone is all right. After that, you're just trying to save lives."

With 10 months of their deployment left, they already, reluctantly, have built up a torrent of experience. "Whenever you deal with death and destruction, you've got to try and be detached," Howard said. "Soldiers get real close out here, and when something happens to one of us, it's like losing a brother.

"After each attack, we hope it won't happen again, but we know it will. As a medic, when I hear the bang, I expect the worst -- that way I can deal more easily with anything less."

The toughest incident Howard's team has confronted happened near the Syrian border. A bomb had blown up one of C Troop's vehicles, and as soldiers moved in to help, a buried artillery round exploded. The second blast caused even more damage than the first, trapping a severely wounded driver inside a destroyed Stryker armored personnel carrier.

The soldier was hit in the leg, chest and head by shrapnel, and he remains hospitalized in critical condition. Doctors fear he has suffered permanent brain damage.

"It was hard to even get him out of the wreckage. He had spinal injuries, his body armor had just been shredded. We gave him morphine for the pain and did the best we could until the helicopter came in to get him away," Howard said. "I can't tell you how good it was to have that bird there."

Capt. Ryan Clairmont, a 29-year-old physician's assistant, was also at the scene of the attack, which he remembers with horror.

"We were on one of those sand trail roads. It was 2 a.m. I heard the explosion, and I just knew. The crew of the vehicle were panicking, there was chaos," he recalled. "The driver was stuck and screaming in pain; he had a spinal injury. We got him out, it was hard. Even with the morphine, he was hurting.

"You just keep telling them they're gonna be OK -- even if they're not -- to try and stop the fear."

Sitting in the emergency room on the remote, windswept base, Clairmont said, "I keep a journal; I put it all on paper, and it helps me come to terms with things.

"I'm a professional, I just walk away. This is my job."

Pausing, he added, "What bothers me most is that we saved him, but I sometimes wonder if that was the best thing. He hasn't fully recovered, and the outcome doesn't look good -- his eyes are open, but there's no brain response. It's something I battle with all the time -- did we actually do him justice by saving his life?"

None of the medics mentioned the wounded man by name. They know who he his, they know his face and his story. But they skirt around getting any more personal.

"You try to just think of the injury. You don't think of the person; you think of the wounds. A ruptured spleen, a broken spine, whatever the case is," Howard said. "At the time, you're just working, all the training kicks in, the world shrinks to just your immediate surroundings, to what your hands are doing.

"For me it's not until afterward that reality comes back, once I've done my job and the guy is on the bird heading out. You suddenly realize what's happened, you think about the guy's family or his kids or his wife."

CHART (1):

Total U.S. casualties in Iraq
Those killed or wounded as of Oct. 26, 2005.
Killed in action: 1,564
Non-hostile deaths: 436
Total deaths: 2,001*
Wounded, returned to duty: 8,061
Wounded, can't return to duty**: 7,159
Total wounded: 15,220
*One of the deaths could not be categorized
** Wounded and can't return to duty is defined as a casualty serious
enough so that the person involved cannot return to duty within 72 hours.
Source: Center for Strategic and International Studies, Department of
Defense, Iraq Coalition Casualty Count, the Washington Post
CHART (2):
U.S. military deaths in major conflicts
In chronological order
Revolutionary War (1775-1783) 4,435*
War of 1812
(1812-1815) 2,260*
Mexican War (1846-1848) 13,283
Civil War (1861-1865) Estimate: 524,332-529,332**
Spanish-American War (1898) 2,446
World War I (1917-1918) 116,516
World War II (1941-1946) 409,399
Korean War (1950-1953) 36,574
Vietnam War (1964-1973) 58,209
Afghanistan (2001-Oct. 15, 2005) 245
Iraq war/occupation (2003-Wednesday ) 2,001
* Includes only those killed in action, not those killed by disease or
privation.
** Authoritative statistics for the Confederate forces are not available.
The final report of the Provost Marshal General, 1836-1866 indicated 133,821
Confederate deaths based on incomplete returns. In addition, an estimated
26,000-31,000 Confederate personnel died in Union prisions.
Source: U.S. Department of Defense, Iraq Coalition Casualty Count
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